Internet-based Framework to Support Integration of Customer in the Design of Customizable Products

A necessary element to design and produce customer-centric products is the integration of customers in the design process. Challenges faced during customer integration into the design process include generating models of the customized product, performing analysis of these to determine feasibility, and optimizing to increase the performance. These tasks have to be performed relatively quickly, if not in real time, to provide feedback to the customer. The focus of this article is to present a framework that utilizes CAD, finite element analysis (FEA), and optimization to integrate the customer into the design process via the Internet for delivering user customized products. The design analysis, evaluation, and optimization need to be automated and enhanced to enable operation over the Internet. A product family CAD/FEA template has been developed to perform analysis, along with a general formulation to optimize the customized product. The CAD/FEA template generalizes the geometry building and analysis of each configuration developed using a product platform approach. The proposed setup is demonstrated through the use of a bicycle frame family. In this study, the focus is on the application of optimization and FEA to facilitate the design of customer-centric products.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Submarine groundwater springs are characterized by distinct fish communities

The inflow of terrestrial groundwater into the ocean is increasingly recognized as an important local source of nutrients and pollutants to coastal ecosystems. Although there is evidence of a link between fresh submarine groundwater discharge (SGD)‐derived nutrients and primary producer and primary consumer abundances, the effects of fresh SGD on the productivity of higher trophic levels such as ichthyofaunal communities remain unclear. To further investigate this relationship, we sampled three sites inside a coral reef lagoon in Mauritius: One site entailing six distinct groundwater springs, a site highly influenced by freshwater influx through the springs, and a strictly marine control site. Using remote underwater video surveys, we found that fish abundances were significantly higher at the groundwater springs than at the other two sampling sites.Principal component analyses showed that the springs and the spring‐influenced part of the lagoon were best described by elevated water nutrient loadings, whereas the control site was characterized by higher water salinity and pH. Macroalgae cover was highest at the control site and the springs. Herbivores and invertivores dominated the fish community at the springs, in contrast to generalists at the control site. At the spring‐influenced site, we mainly encountered high coral/turf algae cover and high abundances of associated fish feeding groups (territorial farmers, corallivores). Our results provide evidence of a fresh SGD‐driven relationship between altered hydrography and distinct fish communities with elevated abundances at groundwater springs in a coral reef lagoon. These findings suggest that the management and assessment of secondary consumer productivity in tropical lagoons should take into account the effects of groundwater springs

De novo implantation vs. upgrade cardiac resynchronization therapy: a systematic review and meta-analysis

Patients with conventional pacemakers or implanted defibrillators are often considered for cardiac resynchronization therapy (CRT). Our aim was to summarize the available evidences regarding the clinical benefits of upgrade procedures. A systematic literature search was performed from studies published between 2006 and 2017 in order to compare the outcome of CRT upgrade vs. de novo implantations. Outcome data on all-cause mortality, heart failure events, New York Heart Association (NYHA) Class, QRS narrowing and echocardiographic parameters were analysed. A total of 16 reports were analysed comprising 489,568 CRT recipients, of whom 468,205 patients underwent de novo and 21,363 upgrade procedures. All-cause mortality was similar after CRT upgrade compared to de novo implantations (RR 1.19, 95% CI 0.88-1.60, p = 0.27). The risk of heart failure was also similar in both groups (RR 0.96, 95% CI 0.70-1.32, p = 0.81). There was no significant difference in clinical response after CRT upgrade compared to de novo implantations in terms of improvement in left ventricular ejection fraction (DeltaEF de novo - 6.85% vs. upgrade - 9.35%; p = 0.235), NYHA class (DeltaNYHA de novo - 0.74 vs. upgrade - 0.70; p = 0.737) and QRS narrowing (DeltaQRS de novo - 9.6 ms vs. upgrade - 29.5 ms; p = 0.485). Our systematic review and meta-analysis of currently available studies reports that CRT upgrade is associated with similar risk for all-cause mortality compared to de novo resynchronization therapy. Benefits on reverse remodelling and functional capacity improved similarly in both groups suggesting that CRT upgrade may be safely and effectively offered in routine practice. CLINICAL TRIAL REGISTRATION: Prospero Database-CRD42016043747

The Prevalence of Human Papillomavirus in Pediatric Tonsils: a Systematic Review of the Literature

BACKGROUND: HPV-related head and neck cancer rates have been increasing in recent years, with the tonsils being the most commonly affected site. However, the current rate of HPV infection in the pediatric population remains poorly defined. The objective of this study was to systematically review and evaluate the prevalence and distribution of HPV in the tonsils of pediatric patients undergoing routine tonsillectomy. METHODS AND RESULTS: The literature was searched using PubMed, EMBASE, Scopus, CINAHL, Cochrane Library, and ProQuest Dissertations & Theses Global databases (inception to December 2017) by two independent review authors. Inclusion criteria included articles which evaluated the prevalence of HPV in a pediatric cohort without known warts or recurrent respiratory papillomatosis, those which used tonsil biopsy specimens for analysis, and those with six or more subjects and clear outcomes reported. Eleven studies met the inclusion criteria. Using the Oxford Clinical Evidence-based Medicine (OCEBM) guidelines, two reviewers appraised the level of evidence of each study, extracted data, and resolved discrepancies by consensus. The systematic review identified 11 articles (n = 2520). Seven studies detected HPV in the subject population, with prevalence values ranging from 0 to 21%. The level of evidence for all included studies was OCEBM Level 3. CONCLUSIONS: HPV may be present in pediatric tonsillectomy specimens; however, the largest included study demonstrated a prevalence of 0%. Future testing should be performed using methods with high sensitivities and specificities, such as reverse transcript real-time PCR or digital droplet PCR

Cardiac Resynchronization Therapy in Patients with Mild Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

# The Author(s) 2011. This article is published with open access at Springerlink.com Objective This review aims at updating the results of cardiac resynchronization therapy (CRT) in mild heart failure patients, and investigating whether CRT can prevent or reverse heart failure progression in an earlier stage. Methods Randomized controlled trials of CRT in patients with New York Heart Association (NYHA) Class I or II heart failure were identified. The effects of CRT on worsening heart failure hospitalization, all-cause mortality, and overall adverse events were meta-analyzed, and the effects of CRT on left ventricular (LV) were systematically reviewed and meta-analyzed. Results Eight studies were identified with a total of 4,302 patients. CRT was associated with a substantial improvement in LVend-systolic volume (WMD −39, 95%CI −41.56 to −36.45). CRT also had a marked effect in reducing new hospitalizations for worsening heart failure by 31 % (RR 0.69, 95%CI 0.60 to 0.79). In addition, CRTsignificantly decreased all-cause mortality by 21 % (RR 0.79, 95%CI 0.67 to 0.93). However, complications in patients with CRT increased by 74 % (RR 1.74, 95%CI 1.44 to 2.11). Conclusions This meta-analysis suggests that CRT could improve the prognosis in patients with mild heart failure and ventricular dyssynchrony, but these improvements are accompanied by more adverse events. Since most patients in the included trials had received ICD therapy, our analysis suggests that CRT could offer an additional benefit. Key words Heart failure. Cardiac resynchronization therapy. Meta-analysi

Microbound larval feed as supplement to live food for milkfish (Chanos chanos Forsskal) larvae

Highly variable results using Brachionus as food for milkfish (Chanos chanos) larvae may be related to: (1) relatively low content of highly unsaturated fatty acids (HUFAs) in Brachionus and (2) inability of first feeding larvae (day 2) to ingest rotifers in sufficient numbers. Early supplemental feeding with a microbound diet high in HUFAs may improve growth and survival of milkfish larvae